Individual
ALEXA NICOLE GRZYWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 EDMUNDSON PL STE 306, COUNCIL BLUFFS, IA 51503-4620
(712) 396-7787
(712) 396-4115
Mailing address
PO BOX 3755, OMAHA, NE 68103-0755
(402) 354-2100
(402) 354-2155
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
073625
IA
363AM0700X
Medical Physician Assistant
1700
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026209700
—
NE
05
—
47068731712
—
NE
Enumeration date
01/23/2013
Last updated
07/21/2022
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